The present invention pertains to surgical training aids, and more specifically to a human torso surgical trainer for performing trauma surgical procedures including diagnostic peritoneal lavage, chest tube insertion, pericardiocentesis, and cricothyroidotomy.
Trauma surgical procedures include those procedures which are usually performed on a person as a result of severe trauma to aid in the diagnosis or to provide immediate life-saving care to maintain the patient alive until more complete medical treatment is available. This may include clearing a blocked airway or draining accumulations of fluids from internal organs. While appearing to be simple procedures, if done improperly, it will result in worsening of the patient""s condition, and placing the patient at an even greater peril of death. By their nature, trauma procedures are usually performed while in a state of emergency. It is useful to provide training methods and apparatus to fully prepare physicians in these procedures.
Medical training and in particular medical students wishing to embark on a trauma surgery practice or practicing surgeons simply wishing to hone their trauma skills, require anatomically correct human models with realistic human tissue textures if they are to be made cognizant of what surgery on live humans is really like. Conventionally, live animals were useful for this purpose. However, the care and housing of live animals is a costly endeavor for many medical schools. Cadavers were also once a staple surgical training aid; however, unclaimed human bodies are becoming a rarity with the newer identification procedures utilizing DNA screening. Animal rights activism has also pushed for and been instrumental in ending the use of live animals for medical testing.
Human anatomical models have been proposed using elastomeric compositions for human tissue. However, to the present, there has not been a surgical trainer which includes a level of detail including the finer aspects of human tissue. The problem with previous attempts to replicate human tissue useful for surgery practice was in failing to recognize the importance of creating not just one layer of approximate overall human tissue consistency, but rather each and every layer must be faithfully replicated to provide a simulated tissue closer to the real thing. The big advance in modeling human tissue is credited to the inventors ability to replicate as accurately as possible each and every membrane of human tissue. This includes the serous membranes surrounding muscle and internal organs, which is a dense tough membrane. With more layers of varying consistencies, and intricate membrane layers, the overall result bears a remarkable similarity to the real thing.
The present invention provides a surgical trainer having a simulated human tissue structure made of an elastomeric composition and having at least one reinforcing layer of a fibrous material. The surgical trainer preferably includes three areas for practicing surgical skills. The first is the abdominal area for practicing diagnostic peritoneal lavage. In a preferred embodiment for practicing this procedure, the surgical trainer includes a simulated tissue structure including a skin layer, a subcutaneous fat layer, an anterior rectus sheath layer, a muscle layer, a posterior rectus sheath layer, an extraperitoneal layer, and a peritoneum layer. Underlying the tissue structure, the trainer includes simulated abdominal organs within an abdominal cavity. The organs and cavity can be filled with simulated bodily fluids to lend more realism to the practice procedure. The second is the chest area. Chest tube insertion and pericardiocentesis are the procedures which can be performed on the trainer for this area. In addition to the simulated tissue structure on the exterior of the chest, the trainer includes additional tissue structure in the form of a layer of simulated tissue to mimic the intercostal muscle and the parietal pleura. To be more lifelike the trainer also includes inflatable lungs to simulate breathing, and ribs. For pericardiocentesis, a sternum, ribs, a heart and additional pericardium tissue structure are included. The heart and pericardium can be filled with simulated bodily fluids to mimic the real life procedure. The third is the neck area. Cricothyroidotomy is the procedure which can be performed on this part of the trainer. In addition to the simulated human tissue structure, the trainer includes a simulated cricoid cartilage, thyroid cartilage, and cricothyroid ligament in this area.
In a preferred embodiment of the human tissue structure, the tissue includes a skin layer of silicone reinforced with a silicone coated fibrous layer, a subcutaneous fat layer of silicone underlying the skin, an anterior rectus sheath layer of silicone reinforced with a silicone coated fibrous layer underlying the subcutaneous fat, a muscle layer of silicone underlying the fat, a posterior rectus sheath layer of silicone reinforced with a silicone coated fibrous layer underlying the muscle, an extraperitoneal layer of silicone underlying the posterior rectus sheath, and a peritoneum of silicone reinforced with a silicone coated layer underlying the extraperitoneal layer. Silicone compositions can be varied for each of the individual layers to mimic the consistency of the analogous human tissue. Pigments can be incorporated to make the simulated tissue visually similar to human tissue. Layers can be bonded to one another or they can be provided as individual members. Layers can also be separated by members not a part of the tissue structure. Further, the layers can be incised and replaced when needed.
In one aspect of the invention, the simulated human tissue can include artificial venous and arterial channels. The channels can be connected to a pump via tubes. The pump draws simulated blood from a reservoir and pumps the blood through the tubes into the channels. When an incision is made in the tissue, and a simulated vein is cut, simulated blood will flood the operative site, as in real life. Preferably, the pump is manually operated such as with a syringe.
In another aspect of the invention, the human tissue structure without more can be used as a surgical trainer to practice suturing and surgical knot-tying.
In yet another aspect of the invention, the human tissue structure is replaceably fastened to the trainer so that it can be replaced when it is at the end of its useful life.
Thus, the present invention provides numerous advantages over the previous models. The present invention is closer to the true texture and consistency of human tissue. The present invention provides fine detail, which is required to faithfully perform certain steps in trauma surgical procedures. The present invention also provides the trainee with truer experiences by simulation complications which would arise if the procedure is done incorrectly.